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PLAMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.Org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SITE ADDRESS <br />IIO PILL ,Avg <br />PARCEL TAX I.D. # <br />604390-1�600600 <br />PERMIT # <br />LIk yli-01L' <br />_ <br />LEGA L0T NO. <br />BLOCK <br />TRACT <br />DESC. <br />OWNER ADDRESS CITY/zIP PHONE <br />G,A R v 7� i �ieS�'� / 2 325 79,01L A4Vc aL . Q.9&05-fz5.5o / -on6l: <br />TENANT NAME CONTACT FOR PERMIT PHONE <br />B 6AQ V TKEM- SEW 426 <br />u t l_:T <br />CONTRACTOR W/N 1)Sj3AZ. ADDRESS CITY2IP PHONE <br />CONTR. LICENSE # PLO 1 W 1 U D S AG 2 3-7 L 1 <br />USE OF BUILDING <br />HEAT SOURCE <br />CONTRACT PRICE OF WORK <br />rr I-Nn . <br />—Electric _ Gas Other <br />-4 1,412.77 <br />_ <br />WORKDESCRIPTION J'NJS'TALL NE-aY C764S H&A-re*__ <br />S1,L) S-1nl 6 A s Live' AflAa o vE Aj)DirloAr4-L hkA r(w-k <br />(}u-rUkaIS--) <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toilet <br />A/C — air handling units <br />_ <br />_ <br />Bathtub <br />Forced air systems <br />_ <br />Lavatory (wash basin) <br />_� <br />Gas piping <br />Shower <br />Water heater <br />_ <br />_ <br />Kitchen sink 8 disposal <br />(=as fireplace <br />Dishwasher <br />Gas range <br />_ <br />Clothes washer <br />Clothes dryer <br />_ <br />Laundry tray <br />Range hood <br />_ <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />_ <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />_ <br />_ <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />_ <br />Grease trap <br />Woodstove <br />Roof drains <br />Other <br />Other <br />i <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 — <br />— <br />1 hereby ceritity that I have read and examined this application and know the same to be true and correct. Al; provisions of laws and <br />ordinates governing this type of work will be complied with whother specified herein or not. The granting o' a permit does not presume <br />to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br />construction. That I am authorized by the owner of this property to cerfcrm the work for which application is made and I r'omply with the <br />State ntractor v .27 ROW and 296.200 WAC. <br />/, .- 9- n <br />Signature o. wn , ont�i' tractor/Autthonzed Agent Ddie <br />